ArticleBulletin of the World Health Organization2019
Care for low back pain: can health systems deliver?
Article in Bulletin of the World Health Organization, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06431503 (Effect of Tok-Sen Massage for Non-specific Low Back Pain), which is not on this map. Cited by 104 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effect of Tok-Sen Massage for Non-specific Low Back Pain
Who cites it
104 citing papers in PubMed, 6 syntheses or guidelines pooled it, 253 citations in OpenAlex.
- Models of care for managing non-specific low back pain.The Cochrane database of systematic reviews · 2025Pooled it
- The effectiveness of non-pharmacological interventions for low back pain in China: A systematic review and network meta-analysis.PloS one · 2025Pooled it
- Systematic review of predictors of hospitalisation for non-specific low back pain with or without referred leg pain.PloS one · 2023Pooled it
- Clinical pathways for the management of low back pain from primary to specialised care: a systematic review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2022Pooled it
- Psychological interventions for chronic, non-specific low back pain: systematic review with network meta-analysis.BMJ (Clinical research ed.) · 2022Pooled it
- Health-care utilisation for low back pain: a systematic review and meta-analysis of population-based observational studies.Rheumatology international · 2019Pooled it
- Modifiable prognostic factors of high societal costs among people on sick leave due to musculoskeletal disorders: a replication study.BMC musculoskeletal disorders · 2024Trial
- Effects of chiropractic spinal manipulation on laser-evoked pain and brain activity.The journal of physiological sciences : JPS · 2021Trial
- Multimodal Non-Surgical Management for Chronic Low Back Pain: A 5-Year Cohort Study from a Tertiary Spine Center in Northwest China.Journal of clinical medicine · 2026Article
- A Hospital Avoidance Pathway With Digitally Supported Follow-Up for Low Back Pain: An Alternative to Emergency Department Care.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
- Attitudes, Beliefs, and Clinical Decision-Making Regarding Low Back Pain: A Cross-Sectional Study of Pakistani Medical Practitioners, Physiotherapists, and Exercise Professionals.Musculoskeletal care · 2026Article
- Factors influencing referrals amongst allied health and medical practitioners managing people with musculoskeletal conditions in Australian primary care.BMC health services research · 2026Article
- What do the general public believe about back pain? A scoping review of population-based studies.BMC public health · 2026Article
- The experiences of physiotherapists regarding self-management practices for patients with non-specific chronic low back pain, South Africa: A qualitative study.The South African journal of physiotherapy · 2026Article
- Implementation of an Australian helpline for low back pain: protocol of a type 2 hybrid effectiveness-implementation trial.BMJ open · 2025Article
- Routine medical care for adults with musculoskeletal disorders in the Indigenous community of Pimicikamak, northern Manitoba before and after implementing the Global Spine Care Initiative model: a retrospective chart review with a 10-month post-implementation window: A collaborative research project between World Spine Care Canada (WSCC), Pimicikamack Okimawin, and Cross Lake Nursing Station.The Journal of the Canadian Chiropractic Association · 2025Article
- Article
- The World Health Organization guideline for non-surgical management of chronic primary low back pain in adults: implications for equitable care and strengthening health systems globally.Global health research and policy · 2025Article
- 'I Have Never Been in That Kind of All-Consuming Pain … I Did Not Know What Else to Do': The Journey to Hospital Admission With Low Back Pain From the Perspectives of Patients.Health expectations : an international journal of public participation in health care and health policy · 2025Article
- Dynamic Cycle of Low Back Pain: A 17-Year, Population-Based Study Analyzing the National Health Insurance Service Data in South Korea.Medicina (Kaunas, Lithuania) · 2025Article
44 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Low back pain is the leading cause of years lived with disability globally. In 2018, an international working group called on the World Health Organization to increase attention on the burden of low back pain and the need to avoid excessively medical solutions. Indeed, major international clinical guidelines now recognize that many people with low back pain require little or no formal treatment. Where treatment is required the recommended approach is to discourage use of pain medication, steroid injections and spinal surgery, and instead promote physical and psychological therapies. Many health systems are not designed to support this approach. In this paper we discuss why care for low back pain that is concordant with guidelines requires system-wide changes. We detail the key challenges of low back pain care within health systems. These include the financial interests of pharmaceutical and other companies; outdated payment systems that favour medical care over patients' self-management; and deep-rooted medical traditions and beliefs about care for back pain among physicians and the public. We give international examples of promising solutions and policies and practices for health systems facing an increasing burden of ineffective care for low back pain. We suggest policies that, by shifting resources from unnecessary care to guideline-concordant care for low back pain, could be cost-neutral and have widespread impact. Small adjustments to health policy will not work in isolation, however. Workplace systems, legal frameworks, personal beliefs, politics and the overall societal context in which we experience health, will also need to change.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.